Citation Nr: 21009684 Decision Date: 02/23/21 Archive Date: 02/23/21 DOCKET NO. 14-35 385A DATE: February 23, 2021 ORDER Entitlement to service connection for a dental disability is denied. Entitlement to service connection for hemorrhoids is denied. Entitlement to service connection for chloracne is denied. Entitlement to service connection for leg rash is denied. Entitlement to service connection for a left leg disability is denied. Entitlement to an initial compensable rating prior to July 18, 2015; a rating in excess of 10 percent from July 18, 2015; and a rating in excess of 40 percent from February 13, 2020 for bilateral hearing loss is denied. Entitlement to an initial rating in excess of 30 percent prior to December 18, 2015, and a rating in excess of 70 percent thereafter for posttraumatic stress disorder (PTSD) is denied. FINDINGS OF FACT 1. The Veteran has not demonstrated a dental disability for which compensation is payable. 2. The preponderance of the evidence of record is against finding that the Veteran has a current diagnosis of hemorrhoids. 3. The preponderance of the evidence of record is against finding that the Veteran has chloracne. 4. The Veteran’s leg rash has not been found to be etiologically related to service including due to herbicide exposure. 5. The preponderance of the evidence of record is against finding that the Veteran has a left leg disability. 6. Prior to July 18, 2015, the Veteran’s bilateral hearing loss has not been manifested by hearing impairment corresponding to a compensable evaluation. 7. From July 18, 2015, the Veteran’s bilateral hearing loss has not been manifested by hearing impairment in excess of 10 percent evaluation. 8. For any period, the Veteran’s bilateral hearing loss has not been manifested by hearing impairment in excess of 40 percent evaluation. 9. Prior to December 18, 2015, the Veteran’s PTSD was not shown to cause occupational and social impairment with reduced reliability and productivity. 10. From December 18, 2015, the Veteran’s PTSD was not shown to cause total occupational and social impairment. CONCLUSIONS OF LAW 1. The criteria for service connection for a dental disability, for compensation purposes, have not been met. 38 U.S.C. § 1712; 38 C.F.R. §§ 3.381, 4.150, 17.161. 2. The criteria for service connection for hemorrhoids have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.303. 3. The criteria for service connection for chloracne have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.303. 4. The criteria for service connection for leg rash have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.303. 5. The criteria for service connection for left leg disability have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.303. 6. Prior to July 18, 2015, the criteria for an initial compensable rating for bilateral hearing loss have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.159, 3.321, 4.3, 4.7, 4.85, 4.86, Diagnostic Code 6100. 7. From July 18, 2015, the criteria for a rating in excess of 10 percent for bilateral hearing loss have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.159, 3.321, 4.3, 4.7, 4.85, 4.86, Diagnostic Code 6100. 8. For any period, the criteria for a rating in excess of 40 percent for bilateral hearing loss have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.159, 3.321, 4.3, 4.7, 4.85, 4.86, Diagnostic Code 6100. 9. Prior to December 18, 2015, the criteria for an initial rating in excess of 30 percent for PTSD have not been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.10, 4.125, 4.126, 4.130, Diagnostic Code 9411. 10. From December 18, 2015, the criteria for a rating in excess of 70 percent for PTSD have not been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.10, 4.125, 4.126, 4.130, Diagnostic Code 9411. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from November 1965 to November 1967, to include service in Republic of Vietnam. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a January 2012 rating decision of a regional office (RO) of the Department of Veterans Affairs (VA). This matter was previously before the Board in May 2018 where it was remanded for additional evidentiary development. Service Connection Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Establishing service connection generally requires competent evidence of three things: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship, i.e., a nexus, between the claimed in-service disease or injury and the current disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). 1. Entitlement to service connection for a dental disability. The Veteran seeks service connection for a dental disability which was claimed as teeth. Dental disabilities are treated differently than medical disabilities in the VA benefits system. 38 U.S.C. § 1712; 38 C.F.R. § 3.381. Treatable carious teeth, replaceable missing teeth, dental or alveolar abscesses, and periodontal disease will be considered service-connected solely for the purpose of establishing eligibility for outpatient dental treatment as provided in 38 C.F.R. § 17.161. As such, service connection for compensation purposes is not available for a dental condition other than one resulting from dental trauma. Dental disabilities that may be awarded compensable disability ratings are set forth under 38 C.F.R. § 4.150. These disabilities include chronic osteomyelitis or osteoradionecrosis of the maxilla or mandible, loss of the mandible, nonunion or malunion of the mandible, limited temporomandibular motion, loss of the ramus, loss of the condyloid or coronoid processes, loss of the hard palate, loss of teeth due to the loss of substance of the body of the maxilla or mandible and where the lost masticatory surface cannot be restored by suitable prosthesis, when the bone loss is a result of trauma or disease but not the result of periodontal disease. 38 C.F.R. § 4.150, Diagnostic Codes 9900-9916. With respect to the dental claim currently before the Board, the Veteran has not requested entitlement to VA outpatient dental treatment. The United States Court of Appeals for Veterans Claims (Court) specifically has held that a claim for service connection for a dental disorder is also a claim for VA outpatient dental treatment. Mays v. Brown, 5 Vet. App. 302 (1993). Based on the record, however, the Board finds that the issue of entitlement to outpatient dental treatment is not currently in appellate status. Further, in compliance with the Board’s remand, the Veteran was afforded a VA examination in October 2019. The examiner opined that the diagnosed loss of teeth was less likely incurred in or caused by service. The examiner indicated that a nexus was not established due to lack of previous dental history and possibility of existing periodontal disease prior to active duty. Considering the evidence, the Board finds that the Veteran does not have a compensable dental disability and he has not submitted evidence showing that he suffers from any of the disabilities included under 38 C.F.R. § 4.150. Moreover, the record does not indicate and the Veteran has not stated that he suffered chronic osteomyelitis or osteoradionecrosis of the maxilla or mandible, loss of the mandible, nonunion or malunion of the mandible, limited temporomandibular motion, loss of the ramus, loss of the condyloid or coronoid processes, loss of the hard palate, loss of teeth due to the loss of substance of the body of the maxilla or mandible and where the lost masticatory surface could not be restored by suitable prosthesis, when the bone loss is a result of trauma or disease but not the result of periodontal disease, loss of the maxilla, or malunion or nonunion of the maxilla. See 38 C.F.R. § 4.150, Diagnostic Codes 9900-9916. Therefore, the criteria for service connection for a compensable dental disability have not been met. 2. Entitlement to service connection for hemorrhoids. In November 2010, the Veteran filed a claim for hemorrhoids which was denied by rating action of January 2012 based on lack of a current diagnosed disability. In compliance with the Board’s remand, the Veteran was afforded a VA examination in November 2019, which the Board finds highly probative. See VA medical opinion dated November 2019. The VA physician found no objective evidence of internal or external current hemorrhoids on examination. The physician also pointed out a GI procedure note where there was no objective evidence of internal or external hemorrhoids at colonoscopy performed at the same VA medical facility in October 2017. Id. The VA physician acknowledged the veteran’s statement of treatment for hemorrhoids during active military service, but explained with citation to medical literature that “the veteran may have experienced an acute case of thrombosed external hemorrhoid treated with thrombectomy, which then resolved without residual.” The VA physician also indicated review of the opinion submitted by P. Y. DC but noted the report was “silent regarding review of the veteran’s STR and all evidence of record.” The physician indicated that he could not comment on its validity as no medical literature was cited for reference. Id. Upon review of the evidence, the Board finds the weight of the evidence is against the finding of a present disability for which entitlement for service connection can be established. Here, the evidence does not show a current diagnosis of internal or hemorrhoids. Indeed, the Board acknowledges the October 2010 opinion from P.Y., a non-treating chiropractor, identified as “diagnostic consultant,” noting a diagnosis of hemorrhoids. The chiropractor indicated the permanent condition is directly and causally related to the veteran’s military service. See Statement from P.Y., Diagnostic Consultant dated October 2010. However, the Board finds the statement carries less probative value as it is unclear whether the chiropractor had access to the entire electronic claims file or what evidence was reviewed or whether a clinical examination was conducted as he presents no supporting evidence for such findings. Prejean v. West, 13 Vet. App. 444 (2000). Consequently, the Board assigns less probative value to the chiropractor’s October 2010 statement. To the extent that the Veteran claims he has a current disability, his lay assertions are not considered competent medical evidence. Although he is certainly capable of describing the history in this case and competent to report symptoms which are within the realm of his personal experience, he is not competent to render a medical diagnosis, as this requires medical expertise. Davidson v. Shinseki, 581 F.3d 1313 (2009). For this purpose, the Board assigns more weight to the medical evidence of record including the VA physician’s November 2019 medical opinion. Therefore, the Board finds that the record is absent for a current disability for which entitlement for service connection can be established, and service connection is not warranted. 3. Entitlement to service connection for chloracne. 4. Entitlement to service connection for leg rash. In November 2010, the Veteran filed a claim for bilateral leg rash and chloracne, which were denied by rating action of January 2012 based on lack of a current diagnosed disability. In compliance with the Board’s remand, the Veteran was afforded a VA examination in November 2019, which the Board finds highly probative. See VA medical opinion dated November 2019. Regarding chloracne, the VA physician found no objective evidence of diagnosis of or treatment for chloracne. The physician explained that “[c]hloracne isn’t actually-like eruption of blackouts, cysts, and pustules more frequently found on the cheeks, behind the ears, and in the armpits and groin region. Examination of the veteran’s skin today reveals no findings consistent with chloracne, either in the above-mentioned most common areas, or on either lower extremity.” The physician also noted review of the nexus statement from P. Y. DC dated October 2010, but found the report “silent regarding how a diagnosis of ‘chloracne’ on parts of the body not normally associated with the disease and with no documented specific findings normally associated with chloracne was arrived at.” For this reason, the VA physician remarked that P.Y.’s “diagnosis is of questionable value.” Id. Regarding leg rash, the VA physician indicated dermatitis or eczema, diagnosis as “unspecified lower extremity rash”. The physician noted the veteran’s report of intermittent exacerbations of the rash on his lower extremities but indicated the record was silent for diagnosis of or treatment for any chronic disability with regard to lower extremity rash. The physician opined that the condition was less likely incurred in or caused by service. In the rationale, the physician stated, “[w]hile the veteran states his symptoms had their onset during active military service and required nearly continuous treatment for the subsequent 45 years prior to establishing as a patient at the VA, review of the veteran’s STR, separation dated 16 November 1967, and C-file are silent for any documentation to support the veteran’s statements.” Id. The physician added that with regard to the veteran’s contention that his current bilateral lower extremity rash is due to or the result of exposure to herbicides, nonspecific rash is not a disease process associated with exposure to herbicides, either by medical literature review or VA statute. Id. Upon review of the evidence, the Board finds the weight of the evidence is against the Veteran’s claim for service connection. Here, evidence does not show a current diagnosis of chloracne and service connection is not established. To that end, the Board finds the October 2010 opinion from P.Y., DC, a non-treating chiropractor, indicating “on visual examination” that the Veteran’s “dermatosis is clearly chloracne” less probative. As pointed out by the November 2019 VA physician, the diagnostic consultant’s “diagnosis is of questionable value” as it is unclear what evidence was reviewed or clinical examination conducted as he presents no supporting evidence for such findings. Accordingly, the Board assigns greater probative value to the November 2019 VA medical opinion and finds the record absent for chloracne, and service connection is not warranted. Similarly, for the claimed leg rash, the Board assigns more weight to the November 2019 VA physician’s opinion which is based on a comprehensive review of the Veteran’s claims file, consideration of lay evidence of record, and provide well-grounded rationale to support the conclusion. The opinion in particular provides substantial reasoning and explanation as to why the Veteran’s current bilateral lower extremity rash is not etiologically related to his active service including herbicide agent exposure. The opinion is sufficient to satisfy the statutory requirements of producing an adequate statement of reasons and bases where the expert has fairly considered material evidence which appears to support the Veteran’s position. Wray v. Brown, 7 Vet. App. 488, at 492-93 (1995). Accordingly, the Board finds great probative value in the November 2019 VA medical opinion. Lastly, the Board observes that the Veteran, as a layperson, is not competent to independently opine as to the specific etiology of a claimed disability or render a medical nexus of a disability to service, as such requires medical expertise and the ability to interpret diagnostic medical testing. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). After weighing all the evidence of record, the Board observes that the medical evidence is significantly probative in determining whether the Veteran has substantiated the claim for service connection. Based on a review of the foregoing evidence and the applicable laws and regulations, the Board finds that the preponderance of the evidence is against the Veteran’s claim for service connection for chloracne and leg rash. The benefit-of-the-doubt doctrine is not for application, and the claims must be denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990). 5. Entitlement to service connection for a left leg disability. In November 2010, the Veteran filed a claim for left leg which was denied by rating action of January 2012 based on lack of a current diagnosed disability. Upon review of the evidence, the Board finds the weight of the evidence is against the finding of a present disability for which entitlement for service connection can be established. Here, the evidence does not indicate a current diagnosis of a left leg disability at any point during the course of this appeal. Specifically, the Veteran’s service treatment records and post-service medical records are absent for any treatment or diagnosis of a left leg disability. In fact, the Veteran’s VA treatment record from September 2011 shows normal finding of the lower extremities. Likewise, there were no reports made by the Veteran or symptoms of a left leg disability on clinical records. Therefore, the Board finds that the record is absent for a current disability for which entitlement for service connection can be established, and service connection is not warranted. Based on a review of the foregoing evidence and the applicable laws and regulations, the Board finds that the preponderance of the evidence is against the Veteran’s claim for service connection for a left leg disability. Accordingly, the claims must be denied. Increased Rating Disability ratings are determined by applying a schedule of ratings that is based on average impairment of earning capacity. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R., Part 4. Each disability must be viewed in relation to its history and the limitation of activity imposed by the disabling condition should be emphasized. 38 C.F.R. § 4.1. Examination reports are to be interpreted in light of the whole recorded history, and each disability must be considered from the point of view of the appellant working or seeking work. 38 C.F.R. § 4.2. Where there is a question as to which of two disability evaluations shall be applied, the higher evaluation is to be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating is to be assigned. 38 C.F.R. § 4.7. 6. Entitlement to an initial compensable rating prior to July 18, 2015’ a rating in excess of 10 percent from July 18, 2015; and a rating in excess of 40 percent from February 13, 2020 for bilateral hearing loss. By rating action of January 2012, service connection for bilateral hearing loss was granted with an initial noncompensable evaluation. By rating action of April 2020, the RO increased the rating to 10 percent effective July 18, 2015, and increased to 40 percent disabling from February 13, 2020. The Board points out that the assigned evaluations for hearing loss are determined by mechanically applying the rating criteria to certified test results. Lendenmann v. Principi, 3 Vet. App. 345, 349 (1992). Under Diagnostic Code 6100, ratings for hearing loss are determined in accordance with the findings obtained on audiometric examination. Evaluations of hearing impairment range from noncompensable to 100 percent based on organic impairment of hearing acuity as measured by the results of controlled speech discrimination tests, together with the average hearing threshold level as measured by pure tone audiometry tests in the frequencies 1,000; 2,000; 3,000; and 4,000 Hertz (cycles per second). To evaluate the degree of disability from hearing impairment, the rating schedule establishes eleven auditory acuity levels designated from Level I for essentially normal acuity through Level XI for profound deafness. 38 C.F.R. § 4.85, Diagnostic Code 6100. As set forth in the regulations, Tables VI, VIa, and VII are used to calculate the rating to be assigned. See 38 C.F.R. § 4.85, Diagnostic Code 6100. Hearing tests will be conducted without hearing aids, and the results of above-described testing are charted on Table VI and Table VII. See 38 C.F.R. § 4.85. In June 2011, the Veteran was afforded a VA audio examination. Results from the audiogram reflect that pure tone air conduction thresholds, in decibels, were as follows: HERTZ 1000 2000 3000 4000 RIGHT 25 35 70 75 LEFT 25 25 45 35 Pure tone threshold averages were 51.25 decibels for the right ear and 32.5 decibels for the left ear. Speech audiometry using the Maryland CNC tests revealed speech recognition ability of 90 percent in the right ear and 98 percent in the left ear. Based on the June 2011 audiogram results, with the utilization of Table VIa, the Veteran has Level II hearing impairment in the right ear and Level I hearing impairment in the left ear. On application of those findings to Table VII, results in a 0 percent disability rating under 38 C.F.R. § 4.85, Diagnostic Code 6100. In July 2015, the Veteran was afforded another VA audio examination. Results from the audiogram reflect that pure tone air conduction thresholds, in decibels, were as follows: HERTZ 1000 2000 3000 4000 RIGHT 40 50 60 50 LEFT 40 70 75 80 Pure tone threshold averages were 50 decibels for the right ear and 66 decibels for the left ear. Speech audiometry using the Maryland CNC tests revealed speech recognition ability of 96 percent in the right ear and 60 percent in the left ear. See July 2015 Hearing Loss and Tinnitus Disability Benefits Questionnaire (DBQ). Based on the July 2015 audiogram results, with the utilization of Table VIa, the Veteran has Level I hearing impairment in the right ear and Level VII hearing impairment in the left ear. On application of those findings to Table VII, results in a 0 percent disability rating under 38 C.F.R. § 4.85, Diagnostic Code 6100. In February 2020, the Veteran was afforded another VA audio examination. Results from the audiogram reflect that pure tone air conduction thresholds, in decibels, were as follows: HERTZ 1000 2000 3000 4000 RIGHT 55 65 70 70 LEFT 55 65 75 75 Pure tone threshold averages were 65 decibels for the right ear and 68 decibels for the left ear. Speech audiometry using the Maryland CNC tests revealed speech recognition ability of 60 percent in the right ear and 56 percent in the left ear. See October 2018 Hearing Loss and Tinnitus DBQ. Based on the February 2020 audiogram results, with the utilization of Table VIa, the Veteran has Level VI hearing impairment in the right ear and Level VIII hearing impairment in the left ear. On application of those findings to Table VII, results in a 40 percent disability rating under 38 C.F.R. § 4.85, Diagnostic Code 6100. As demonstrated above, the evaluation for hearing loss is based on objective testing. The Board observes that for the period prior to February 2020, the objective results of the June 2011 and July 2015 audio examinations do not support higher ratings under the relevant criteria under 38 C.F.R. § 4.85, Diagnostic Code 6100. Further, although the results of the July 2015 VA examination reflect hearing loss has been manifested by hearing impairment corresponding to a noncompensable evaluation, the AOJ awarded a 10 percent rating effective July 18, 2015, which the Board does not disturb. Indeed, there has been worsening of the Veteran’s hearing loss as demonstrated in the recent February 2020 VA contract examination, where a 40 percent disabling rating has already been assigned since February 13, 2020. The objective VA examinations do not support an assignment of a disability rating in excess of what the AOJ has already awarded. Thus, a higher rating in excess of 40 percent for hearing loss at any point during the appeal period is denied. 38 C.F.R. § 4.85, Diagnostic Code 6100. The Board has considered the Veteran’s contentions with regard to his claim for higher ratings. Although the Board does not doubt the sincerity of the Veteran’s belief that his disability is more severely disabling than reflected in the current rating, as a lay person without the appropriate medical training or expertise, he simply is not competent to provide a probative opinion on a medical matter, such as the severity of a current disability as evaluated in the context of the rating criteria. Bostain v. West, 11 Vet. App. 124, 127 (1998). Further, the Board observes that the above 2011, 5015, 2020 VA audiological examinations are based on consideration of the applicable provisions of VA’s rating schedule and consider the Veteran’s statements of the effects of his hearing impairments on his daily life. Martinak v. Nicholson, 21 Vet. App. 447 (2007). However, even with consideration of those problems, a rating higher than the currently assigned is not warranted under the relevant criteria. Given the foregoing reasons, the Board finds that increased ratings are not warranted, and the claim must be denied. 7. Entitlement to an initial rating in excess of 30 percent prior to December 18, 2015, and a rating in excess of 70 percent thereafter for PTSD. By rating decision of January 2012, service connection for PTSD was granted with an initial rating of 30 percent effective October 28, 2010. Thereafter, in a July 2016 rating decision, the RO increased the evaluation for PTSD to 70 percent disabling effective December 18, 2015. The Veteran continues to seek higher ratings. The Veteran’s PTSD has been rated under Diagnostic Code 9411, which is rated under the General Rating Formula for Mental Disorders. 38 C.F.R. § 4.130, Diagnostic Code 9411. Under the General Rating Formula for Mental Disorders, a 30 percent evaluation is assigned when a veteran’s mental disability causes occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events). 38 C.F.R. § 4.130, Diagnostic Code 9411. A 50 percent rating requires occupational and social impairment, but with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete task); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; and difficulty in establishing and maintaining effective work and social relationships. Id. A 70 percent rating is warranted for even greater occupational and social impairment with deficiencies in most areas, such as work, school, family relationships, judgment, thinking or mood, due to such symptoms as: suicidal ideation; obsessional rituals that interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a work-like setting); and inability to establish and maintain effective relationships. Id. A 100 percent rating is warranted if there is total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation or own name. Id. When rating a mental disorder, VA must consider the frequency, severity, and duration of the Veteran’s psychiatric symptoms, the length of remissions, and the Veteran’s capacity for adjustment during periods of remission. The rating agency must assign a rating based on all the evidence of record that bears on occupational and social impairment, rather than solely on the examiner’s assessment of the level of disability at the moment of the examination. When rating the level of disability from a mental disorder, the rating agency must consider the extent of social impairment, but cannot assign a rating solely on the basis of social impairment. 38 C.F.R. § 4.126. The Veteran’s actual symptomatology, and resulting social and occupational impairment, will be the primary focus when assigning a disability rating for a mental disorder, and the Veteran may qualify for a particular rating by demonstrating the particular symptoms associated with that percentage, or other symptoms of similar severity, frequency, and duration. Vazquez-Claudio v. Shinseki, 713 F.3d 112, 116-17 (Fed. Cir. 2013). In October 2011, the Veteran was afforded an initial VA examination for PTSD. On clinical interview, the Veteran reported being twice divorced and currently in a long term relationship. Although poor relationships with his three biological children, he reported having positive relationships with his step children. He reported having a “successful career” worked 43 years with the same company (Florida Power and Light) and retired in 2011. The examiner indicated a current diagnosis of PTSD and determined the level of impairment as, “a mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication.” See Initial PTSD Disability Benefits Questionnaire dated October 2011. In May 2016, the Veteran submitted a Review PTSD DBQ completed by a private psychologist, S.F., PsyD. dated April 2016, who commented that the Veteran is “unable to function in any occupational capacity, sedentary or otherwise, without being a threat to self or others.” The examiner also noted that the Veteran “isolates with few friends (military or law enforcement). As to the functional level, the examiner indicated, “occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking and/or mood.” report of currently experiencing “chronic difficulties with anxiety, depression, concentration, attention, fatigue, guilt, irritability, racing thoughts, sleep disturbances, and avoidance of stimuli such as loud noises.” See Review PTSD DBQ dated April 2016 completed by private psychologist. The record shows a December 2018 statement from the same private psychologist, S.F., PsyD., who indicated that the Veteran’s condition has deteriorated to the point where he is unemployable secondary to the severity of his symptoms. The psychologist stated that the Veteran is “unable to function in any occupational capacity, to include sedentary, without begin a threat to self or others.” See Statement from S.F., PsyD dated December 2018. However, no supporting treatment records or clinical evaluation was submitted with the letter. In compliance with the Board’s May 2018 remand, the Veteran was afforded a VA contract examination in February 2020. The examiner observed the Veteran was appropriately dressed and groomed, an active participant and appeared to put forth his best effort. There was no evidence of over-exaggeration or minimization of symptoms. The examiner noted the Veteran’s predominant clinical presentation was irritable/angry. His insight and judgment appeared intact. The Veteran denied any suicidal or homicidal ideation, intent, or plan. The examiner noted the last VA psychology/mental health related treatment was found in March 2016, where the Veteran participated in 5 sessions. The examiner indicated the functional level as “occupational and social impairment with reduced reliability and productivity.” See VA contract examination dated February 2020. Notably, the February 2020 VA contract examiner commented on the outside VA treatment records submitted by the Veteran. Specifically, the examiner remarked that the private psychologist S.F. “is somewhat well-known within the disability-seeking veteran populations within the Central Florida area as a good person to go for favorable evaluations…. often based solely on claimant’s self-report of symptoms even when this is often very much discrepant with all other objective evidence in records.” The VA contract examiner further added there is no evidence of “treatment notes, therapy sessions through Baytree behavior to confirm that actual treatment is occurring, specific areas being addressed, content, dates of treatment” or precisely what services were rendered to justify his conclusions. Thus, the examiner commented the records from this provider, S.F., is viewed “with a fair degree of skepticism due to the frequent lack of objective evidence proffered to justify his conclusions.” Id. Prior to December 18, 2015, the Board finds that the preponderance of the evidence is against a finding of entitlement to an evaluation exceeding 30 percent for this period on appeal. The record does not establish that the Veteran’s PTSD results in occupational and social impairment with reduced reliability and productivity due to such symptoms as flattened affect, circumstantial, circumlocutory, or stereotyped speech, panic attacks more than once a week, difficulty in understanding complex commands, impairment of short and long-term memory, impaired judgment, impaired abstract thinking, disturbances of motivation and mood, or difficulty in establishing and maintaining effective work and social relationships. With regard to occupational and social functioning, the June 2011 VA examiner noted the Veteran retired in 2011 after having a “successful career” of over 40 years with the same company. The record reflects that the Veteran is able to establish and maintain relationships with family, friends or acquaintances. In fact, the Veteran also reported being in a “satisfied” long term relationship with the woman he lives with, and “positive relationships” with his step children. Consequently, the Board concludes that the Veteran’s PTSD does not impact his social and occupational functionality in such a way to result in occupational and social impairment, with reduced reliability and productivity or with deficiencies in most areas. Thus, for the period prior to December 18, 2015, the evidence does not reflect that the Veteran’s PTSD has been manifested by symptoms of such severity to warrant a higher rating. Accordingly, an initial rating in excess of 30 percent is not supported and the claim must be denied. 38 C.F.R. § 4.130, Diagnostic Code 9411. For the period from December 18, 2015, the Veteran is adequately compensated by the currently assigned 70 percent evaluation for PTSD, and higher rating of 100 percent is not warranted for any time for the entire appeal period. 38 C.F.R. §§ 4.3, 4.7, 4.130, Diagnostic Code 9411. Although the record shows that the Veteran experienced PTSD symptoms of suspiciousness, disturbances of motivation and mood, difficulty in establishing and maintaining work and social relationships, and difficulty in adapting to stressful circumstances, it cannot be concluded that the Veteran has established total occupational and social impairment. 38 C.F.R. § 4.130. Critically, the Veteran consistently denied any history of suicidal attempts and expressly denied any active suicidal or homicidal ideations. He also denied any intent and/or plan to hurt himself or others. In fact, there is no evidence to show that at any time during the appeal period the Veteran exhibited or resorted to violence or acted upon such impulses. Furthermore, at no time, does the evidence of record show that the Veteran had other symptoms characteristic of a 100 percent evaluation such as persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others. Moreover, the Board observes that the Veteran’s relevant mental history and material evidence of record were specifically considered by the medical professionals in formulating their assessments in 2016, 2018, and 2020. In fact, the February 2020 VA contract examination demonstrates an improvement in the Veteran’s functional impairment as “occupational and social impairment with reduced reliability and productivity.” In short, the record simply does not establish that his PTSD results in total occupational and social impairment. Thus, the Board finds that the next higher rating of 100 percent is not warranted. 38 C.F.R. § 4.130, Diagnostic Code 9411. Based on a review of the foregoing evidence and the applicable laws and regulations, the Board finds that the preponderance of the evidence is against the Veteran’s claim for a rating in excess of 70 percent for PTSD for any time of the appeal period. The benefit-of-the-doubt doctrine is not for application, and the claim must be denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990).] KELLI A. KORDICH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. An, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.